目的 观察小于胎龄(SGA)儿生后追赶性生长的临床特征，为科学评价和促进SGA儿生长发育提供依据。方法 本研究纳入2019年6月—2020年12月于南京市儿童医院儿童保健科门诊体检儿童，对符合出生体重或身长小于P10的SGA儿，进行体格测评、发育评估、营养评估并定期随访。按体重和/或身长增加标准差评分SDS是否大于0。67分为有追赶生长(CUG)组和无追赶(NCUG)组。神经发育采用发育筛查测验。结果 169例SGA儿纳入研究(男:69例，女:100例)。CUG组72例(42。6％)，NCUG组97例(57。4％)。CUG组的身长Z评分从6月龄开始高于NCUG组(t=5。523，P＜0。001)，体重Z评分则从3月龄时开始高于NCUG组(t=2。206，P＜0。05)，头围Z评分从1月龄开始大于NCUG组(t=5。092，P＜0。001)，BMI Z评分从3月龄时开始明显高于NCUG组(t=2。958，P＜0。05)。CUG组6月龄前生长速度达高峰，并达到追赶性生长标准(△ Z＞0。67)。CUG组SGA儿生后神经心理发育评分高于NCUG组(DQ分数:t=3。966，P＜0。001;MI分数:t=3。151，P＜0。05)。CUG组中营养强化配方喂养的SGA儿生后3月龄和6月龄身长Z评分(t=2。707、2。386)、体重 Z 评分(t=2。235、2。931)及 BMI Z 评分(t=3。263、3。824)均大于纯母乳喂养者(P＜0。05)，头围Z评分差异无统计学意义(P＞0。05)。结论 有追赶性生长的SGA儿生后体格增长速度、神经发育水平明显高于无追赶性生长的SGA儿。生后6个月是追赶性生长的高峰期。在有追赶性生长的儿童中，营养强化配方喂养方式较母乳喂养能促进身长和体重更快达成追赶性生长并增加BMI。
Clinical characteristics of catch-up growth in small for gestational age infants
Objectives To analyze the clinical characteristics of catch-up growth in small-for-gestational age(SGA)infants,so as to provide scientific basis for evaluating the growth and development and to promote the healthy growth of SGA infants.Methods SGA infants who initially visited a paediatrician in the Department of the Children's Health Care of Nanjing Children's Hospital between June 2019 to December 2020,whose birth weight met the criteria and/or birth lengths was under the 10th percentile(＜P10)were enrolled in this study to took routine physical examinations,and were followed up regularly.Then SGA infants were divided into catch-up growth(CUG)and non catch-up growth(NCUG)groups according to whether Z-scores of weight and/or length increase was greater than 0.67.The neuropsychological development scores was tested by development screen test(DST).Results A total of 169 SGA infants were included in this study,including 69 boys and 100 girls.There were 72 cases(42.6％)in CUG group and 97 cases(57.4％)in NCUG group.Z-score of length in CUG group was significantly higher than that in NCUG group since 6 months old(t=5.523,P＜0.001).Z-score of weight(t=2.206,P＜0.05)and body mass index(BMI)Z-score(t=2.958,P＜0.05)in CUG group was significantly higher than that of NCUG group since 3 months old.Z-score of head circumference for age in CUG group was significantly higher than that of NCUG group from 1 month old(t=5.092,P＜0.001).The growth rate of CUG group reached the peak before 6 months of age,and reached the catch-up growth standard(△Z＞0.67).DST scores in the CUG group were higher than those in the NCUG group(DQ t=3.966,P＜0.001;MI t=3.151,P＜0.05).At the age of 3 and 6 months after birth,Z-scores of length(t=2.707,2.386),the Z-scores of weight(t=2.235,2.931)and the Z-scores of BMI(t=3.263,3.824)of infants fed with fortified nutrition formula in the CUG group were significantly higher than those of exclusive breastfeeding(P＜0.05),but there was no significant difference in Z-scores of head circumference(P＞0.05).Conclusions The postnatal physical growth rate,neurodevelopment level in SGA infant with catch-up growth are significantly higher than those without catch-up growth.The peak of catch-up growth occurrs at 6 months after birth.In children with catch-up growth,nutritional supplementation formula feeding can promote body length and weight,thus reaching catch-up growth faster and increasing BMI.
small for gestational agecatch-up growthclinical characteristics
万方数据
维普
